Northampton County clerical specialist Sharon Wengryn had been limping for months when she decided to finally have foot surgery last week.

Turns out, her decision had less to do with the fact that her doctor has been recommending it for months and everything to do with the reality that the year is about to end.

For Wengryn and all of the 1,800 full-time county workers, the same medical procedure that comes almost free this month could cost hundreds or even thousands of dollars starting Jan. 1. So, now she's part of an unusually brisk procession of county employees rushing to the hospital to get expensive medical procedures done before the clock runs out on their current health care benefits.

"I probably should have done it sooner, but the health-care change got me moving," Wengryn said. "I don't have thousands of dollars to pay for this. I know a lot of county workers who are out this month with surgeries."

Under their new plan that begins New Year's Day — the one they've been protesting since July — county workers will be footing the bill for 10 percent of their heath-care costs. So, for a typical knee surgery with an average cost of $23,000, next year means an out-of-pocket bill of $2,300 — a bill that this month is probably $0 to $500.

Given that kind of math, the line to the surgery table isn't entirely unexpected.

"With the health-care changes, we anticipated that there would be a spike at the end of the year," county Fiscal Affairs Director James Hunter said. "We're self-insured, so the bills come directly to us weekly. We can see that there's been an increase."

Because individual medical records are private, it's unclear how much of the current spike can be attributed to employees trying to beat the calendar, but the late-year increase is undeniable. The most recent batch of medical bills that arrived at the county Dec. 19 totaled $703,000. That's up 63 percent from $430,000 the week before, and 92 percent higher than the $367,000 the week before that.

Because a single heart procedure by just one employee can push a weekly bill into the stratosphere, it's unclear how much of the spike can be attributed to people hurrying to get work done under the old plan, but there's no question the late expenses are putting the county over its annual medical budget.

The county budgeted $24.5 million for the medical costs of its retirees and full-time employees, a figure that's up 40 percent since 2009.

The Dec. 19 bill brought the 2014 total to $26.03 million, and with one more bill due before the end of the year, the final total is likely to surge beyond $26.5 million — a full $2 million over budget, according to fiscal affairs officials.

County Executive John Brown points to that big number to justify the medical plan changes that are being forced on county workers. Under the current plan, workers on a single plan pay $250 in deductibles per year and those on a family plan pay $500 per year.

Under the new plan, the single deductible is doubled to $500 and the family quadrupled to $2,000. In addition, employees now have co-pays for visits and must pay 10 percent of all costs after the deductible is met, for a maximum out-of-pocket of $2,500 for single-plan employees and $4,000 for those on the family plan. The bottom line is that what now costs the single-plan employee $250 a year next year could cost as much as $2,500, while a family plan worker's $500 bill could increase to $4,000.

It's a change that's caused more than an unusually brisk procession of workers headed for end-of-year surgeries. A record 124 employees have decided to retire before the new year, and the American Federation of State, County and Municipal Employees union representing 1,200 county workers has filed a complaint with the Pennsylvania Labor Relations Board.

Employees demonstrating outside the Easton courthouse Monday gave Brown a bag of coal for Christmas, but Brown remains steadfast that the change is necessary.

"We could have sat down and discussed all this," said Justus James, president of AFSCME. "He didn't have to do it this way."